The insertion of a medical instrument or implant through tissue can involve the application of significant mechanical force. For example, the insertion of a suture through thick connective tissue requires substantial pressure, regardless of whether the suture is pushed or pulled through the tissue. In an open surgical procedure, the exposure of the large surgical incision provides access for manipulation and visualization. Nevertheless, insertion can still be problematic. Furthermore, it is often desirable to minimize the size of this incision to reduce scarring and soft tissuetrauma.
Arthroscopy and other minimally invasive surgical procedures utilize small incisions or portals for insertion of diagnostic and surgical instruments manipulated externally of the body, and therefore, avoid the trauma associated with large incisions as well as the hospitalization and prolonged recovery periods required with open surgery. While it is not always required, an endoscope may be used to enhance visualization. However, due to the small surgical incision of these minimally invasive approaches, it is frequently difficult to gain the access required to insert and manipulate the instrument or implant. Remotely passing a suture through tissue can be one particularly troublesometask.
The prior art teaches a number of devices attempting to solve this problem. For example, the Carter-Thomason suture passer disclosed in U.S. Pat. No. 5,496,335 has a sharp tip that opens and closes so that the tip can both grasp the suture and penetrate through tissue. However, this instrument, like most, if not all, relies solely on mechanical force to pass the suture through tissue.
Thus, there exists a need for an improved suture inserter and method.